African Journal of Respiratory Medicine received 855 citations as per google scholar report
Introduction: The coexistence of tuberculosis and diabetes poses a significant public health challenge, requiring integrated and careful management to optimize treatment and minimize risks. This study aims to analyze the progression of tuberculosis in diabetic patients.
Methodology: We conducted a longitudinal study from February to October 2023. The study included 73 patients with bacteriologically confirmed pulmonary tuberculosis, divided into three groups: (1) Diabetic patients, (2) prediabetic patients, (3) non-diabetic control patients. The patients were followed for 9 months of treatment, and anti-tuberculosis therapeutic success was determined as follows: Cure, treatment failure, death, and loss to follow-up. Survival analysis using Cox proportional regression was used to compare each group based on therapeutic success. The analyses were conducted using the R software.
Results: Out of 73 tuberculosis patients, 26 (35.6%) were diabetic, 27 (36.9%) were prediabetic, and 20 (27.3%) were non-diabetic controls. The results show that patients in the diabetic group (Group 1) had a significantly increased risk of death compared to the control group, with a hazard ratio (HR) of 3.8 (95% CI 3.1-4.6, p<0.001). Similarly, the prediabetic group (Group 2) had an HR of 2.3 (95% CI 1.9-3.0, p<0.001) for death, indicating a substantial risk compared to controls. Compared to prediabetics, diabetic patients had an HR of 1.6 (95% CI 1.2-2.1, p<0.001), indicating a higher risk of death. Regarding treatment failure, diabetic patients had an HR of 3.5 (95% CI 2.7-4.7, p<0.001), while prediabetics had an HR of 2.5 (95% CI 1.9-3.3, p<0.001) compared to controls. Compared to prediabetics, diabetics had an HR of 1.4 (95% CI 1.1-1.9, p=0.01) for treatment failure. Regarding the treatment success outcome, controls showed a higher likelihood of cure with an HR of 0.6 (95% CI 0.4-0.8, p=0.001), followed by prediabetic patients with an HR of 1.4 (95% CI 1.1-1.8, p=0.02), while diabetic patients had the highest HR of 2.2 (95% CI 1.8-2.7, p<0.001). The comparison between the diabetic and prediabetic groups revealed an HR of 1.6 (95% CI 1.2-2.1, p<0.001) for cure, indicating that diabetic patients had a lower chance of recovery.
Conclusion: Our results show the impact of diabetes on treatment outcomes, highlighting the need for special attention to drug interactions, strict glycemic control, and support for treatment adherence.
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